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Multisystems > Multisystems Midterm > Flashcards

Multisystems Midterm Flashcards

1
Q

Staphylococcus aureus

A

Gram + cocci in clusters Catalase + Coagulase + a/w acute endocarditis in IV drug abusers Large vegetations that destroy the valve, commonly tricuspid Secondary bronchopneumonia, blepharitis, conjuctivitis, endophthalmitis (post-surgical, post-trauma, hematogenous), otitis externa, sinusitis

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2
Q

Streptococcus pneumoniae

A

Gram + diplococci Catalase - Alpha hemolytic Optochin sensitive Bile soluble Most common cause of community-acquired pneumonia Most common cause of bacterial meningitis in infants, children, adults a/w endocarditis in alcoholics, otitis media, conjuctivitis, sinusitis

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3
Q

Haemophilus influenzae

A

Gram - coccobacilli Catalase + Oxidase + Culture on blood agar Requires factors X (hemin) and V (NAD) to grow Type b (Hib) is capsulated and causes meningitis in infants, epiglottitis, cellulitis, pneumonia (secondary, COPD), conjuctivitis, otitis media, sinusitis

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4
Q

Respiratory Syncytial Virus (RSV)

A

Paramyxovirus Enveloped -ssRNA –> must bring RNA-dependent RNA polymerase Helical Replicates in cytoplasm F (fusion protein) causes respiratory epithelial cells to fuse Replicates in the cytoplasm (syncitia) Pink cytoplasmic inclusions Causes URT, croup, bronchiolitis, pneumonia in infants Winter epidemic

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5
Q

Klebsiella pneumoniae

A

Gram - rod Lactose fermenter Thick mucoid capsule –> current jelly suputum Pneumonia in malnourished, alcoholics, diabetics

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6
Q

Pseudomonas aeruginosa

A

Gram - rod Lactose non-fermenter Oxidase + Smells like artificial grape Produces green pigment (pyocyanin) Causes pneumonia in CF patients, hot tub folliculitis, otitis externa, otitis media, UTIs, infectious keratitis, endophthalmitis (post-traumatic) Treat with aminoglycoside plus extended-spectrum penicillin (e.g. piperacilin)

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7
Q

Legionella pneumophila

A

Gram - rod (gram stains poorly but can use silver stain) LPS can be detected in a urine sample Culture on charcoal yeast with iron and cysteine Causes GI symptoms + pneumonia (typical and atypical) Treat with macrolide or quinolone

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8
Q

Mycoplasma pneumonia

A

Atypical pneumonia in young adults in close quarters

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9
Q

Chlamydia pneumonia

A

Atypical pneumonia in young adults

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10
Q

Cytomegalovirus

A

Enveloped, dsDNA virus May cause TORCH congenital infection: periventricular calcifications, sensorineural hearing loss Diagnose with nasal culture Atypical pneumonia in the immunosuppressed (e.g. HIV) Nuclear and cytoplasmic inclusions Treat with ganciclovir

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11
Q

Mycobacterium tuberculosis

A

Gram + like (but won’t gram stain) Mycolic acid in cell envelope –> acid fast stain Aerobic Causes TB (can be latent, reactivated, miliary, disseminated) Characterized by Ghon complex in mid zone of lung (primary infection), caseating granuloma, or secondary infection (cavitary lesion in upper lobes) Can spread hematogenously and effect vertebrae and cranial nerves Treat with RIPE

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12
Q

What kind of infections are associated with Candida?

A

Oral candidiasis, endophthalmitis, chorioretinitis, otitis externa

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13
Q

What kind of infections are associated with aspergillus?

A

Endophthalmitis, chorioretinitis, otitis externa, chronic sinusitis

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14
Q

Candida (C. albicans)

A

Yeast Pseudohyphae, true hyphae, germ tubes, and budding yeasts Can cause candidiasis (oral, esophageal) in immunocompromised patients Can cause yeast infections in women –> thick white discharge; treat with OTC azole-based ointments or oral fluconazole Treat disseminated candida with fluconazole, amphotericin B, or caspofungin

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15
Q

What can cause a positive PPD test?

A

Current TB infection Past TB exposure BCG vaccination

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16
Q

What can cause a false negative PPD test?

A

Steroid use Malnutrition Immunocompromised Sarcoidosis

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17
Q

What can cause a positive PPD test?

A

Current TB infection Past TB exposure BCG vaccination

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18
Q

What can cause a false negative PPD test?

A

Steroid use Malnutrition Immunocompromised Sarcoidosis

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19
Q

Mycobacterium leprae

A

Acid-fast bacillus Likes cool temperatures so affects skin and nerve of the hands and feet Armadillos serve as reservoir Lepromatous form –> Th2 response; treat with dapsone, rifampin, clofazimine for 2-5 years Tuberculoid form –> Th1 response; treat with dapsone and rifampin for 6 months

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20
Q

Aspergillus fumigatus

A

Mold fungus (not dimorphic) Hyphae branch at acute angles Causes invasive aspergillus, allergic bronchopulmonary aspergillosis (Type 1 hypersensitivity a/w asthma, CF), aspergillomas (esp. after TB), hepatocellular carcinoma (via aflatoxins)

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21
Q

Pneumocystis jirovecii

A

Yeast that can’t be cultured Can cause pneumocystic pnemonia (PCP) in immunosuppressed patients Ground-glass appearance on CXR Treatment and prophylaxis with TMP-SMX Prophylaxis when CD4 counts

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22
Q

Mucor

A

Mold Large hyphae branch at obtuse angles Causes mucormycosis, facial ischemia in diabetics and leukemic patients –> fungi proliferate in blood vessels when glucose and ketones are high Can penetrate brain Treat with amphotericin B, poscanazole

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23
Q

Rubella virus

A

Togavirus Enveloped +ssRNA Icosahedral pH-dependent endocytosis Causes fever, lymphadenopathy, arthralgias, and fine rash that starts on the face and spreads to the rest of the body (first manifestation) Can cause TORCH infection in newborns (transplancental, esp. 1st trimester) –> petechial rash, deafness, blindness/cataracts, heart and brain defects

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24
Q

Polio virus

A

Pircornavirus Non-enveloped +ssRNA Icosahedral

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25
Q

Parainfluenza

A

Paramyxovirus Enveloped -ssRNA –> must bring RNA-dependent RNA polymerase Helical Replicates in the cytoplasm F (fusion protein) causes respiratory epithelial cells to fuse (syncitia) Causes croup Autumn epidemic

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26
Q

Measles

A

Paramyxovirus Enveloped -ssRNA –> must bring RNA-dependent RNA polymerase Helical Replicates in the cytoplasm F (fusion protein) causes respiratory epithelial cells to fuse (syncitia) Koplik spots (red spots with blue-white center on buccal mucosa) precede descending maculopapular rash (CTL response) Sequelae include: post-infectious encephalitis, acute disseminated encephalomyelitis (ADEM), measles inclusion body encephalitis (MIBE), subacute sclerosing panencephalitis (SSPE), giant cell pneumonia (in immunosuppressed)

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27
Q

Mumps

A

Paramyxovirus Enveloped -ssRNA –> must bring RNA-dependent RNA polymerase Helical Replicates in the cytoplasm F (fusion protein) causes respiratory epithelial cells to fuse (syncitia) Causes parotitis, orchitis (usually unilateral, can cause infertility in teenagers), meningitis

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28
Q

What respiratory infections are associated with AIDS?

A

CMV pneumonia Aspergilllosis Pneumocystis peumonia –> Pneumocystis jirovecii Pneumonia –> S. pneumoniae TB-like disease –> Mycobacterium avium-intracellulare (Mycobacterium avium complex [MAC])

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29
Q

Mycobacterium avium-intracellulare

A

Causes TB-like disease –> Mycobacterium avium complex (MAC) When CD4 count

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30
Q

What are dermatologic infections associated with AIDS?

A

Candidiasis of mouth, esophagus Hairy leukoplakia on lateral tongue –> EBV Bacillary angiomatosis –> Bartonella henselae

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31
Q

What are neurologic infections associated with AIDS?

A

Ring-enhancing lesions –> Toxoplasma gondii Dementia Encephalopathy –> JC virus reactivation Meningitis –> cryptococcus neoformans Retinitis –> CMV (cotton-wool spots)

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32
Q

What are oncologic disease associated with AIDS?

A

Non-Hodgkin lymphoma –> EBV Primary CNS lymphoma –> EBV Squamous cell carcinoma of rectum or cervix –> HPV Kaposi sarcoma –> HHV-8

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33
Q

What respiratory infections are associated with AIDS?

A

CMV pneumonia Aspergilllosis Pneumocystis peumonia –> Pneumocystis jirovecii Pneumonia –> S. pneumoniae TB-like disease –> Mycobacterium avium-intracellulare (Mycobacterium avium complex [MAC])

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34
Q

Mycobacterium avium-intracellulare

A

Causes TB-like disease –> Mycobacterium avium complex (MAC) When CD4 count

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35
Q

What are dermatologic infections associated with AIDS?

A

Candidiasis of mouth, esophagus Hairy leukoplakia on lateral tongue –> EBV Bacillary angiomatosis –> Bartonella henselae

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36
Q

What are neurologic infections associated with AIDS?

A

Ring-enhancing lesions –> Toxoplasma gondii Dementia Encephalopathy –> JC virus reactivation Meningitis –> cryptococcus neoformans Retinitis –> CMV (cotton-wool spots)

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37
Q

What are oncologic disease associated with AIDS?

A

Non-Hodgkin lymphoma –> EBV Primary CNS lymphoma –> EBV Squamous cell carcinoma of rectum or cervix –> HPV Kaposi sarcoma –> HHV-8

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38
Q

Human Immunodeficiency Virus (HIV)

A

Retrovirus 2 copies +ssRNA Enveloped Reverse transcriptase

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39
Q

Herpes Simplex Virus (HSV)

A

Enveloped, dsDNA virus Infects mucosa epithelial cells Causes vesicles or ulcers on mouth, genitals Can cause congenital herpes, keratitis Treat with acyclovir, valacyclovir, ganciclovir

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40
Q

Acyclovir

A

Treats herpes infections (HSV-1, HSV-2, VZV) Guanosine analog –> primary phosphorylation by viral thymidine kinase –> inhibits viral DNA polymerase by chain termination

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41
Q

Valacyclovir

A

Treats herpes infections (HSV-1, HSV-2, VZV) Guanosine analog –> primary phosphorylation by viral thymidine kinase –> inhibits viral DNA polymerase by chain termination Prodrug of acyclovir, activated in the liver, higher bioavailability

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42
Q

Which anti-retrovirals have activity against HBV?

A

Lamivudine (NRTI) Tenofovir (Nucleotide RTI) Emtricitabine (NRTI)

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43
Q

Hepatitis B virus

A

Enveloped, circular DNA virus Parenteral, sexual, maternal-fetal transmission HBV DNA polymerase has DNA and RNA-dependent functions HBV DNA polymerase completes partial dsDNA –> incorporated into host genome –> host RNA polymerase makes mRNA –> HBV DNA polymerase reverse transcribes mRNA into DNA to form new viral particle

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44
Q

Hepatitis C virus

A

RNA flavivirus Transmitted via blood (IVDU, post-transfusion), sex Causes cirrhosis, hepatocellular carcinoma Treat with INFα, ribavirin, sofosbuvir

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45
Q

Zidovudine (AZT)

A

Nucleoside Reverse Transcriptase Inhibitor (NRTI) Used as prophylaxis or treatment of HIV; safe in pregnancy to reduce transmission Side effects include lactic acidosis, macrocytic anemia, neutropenia

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46
Q

Emtricitabine

A

Nucleoside Reverse Transcriptase Inhibitor (NRTI) Treats HIV and HBV Side effects include lactic acidosis

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47
Q

Abacavir

A

Nucleoside Reverse Transcriptase Inhibitor (NRTI) Treats HIV Need to genotype patient to prevent hypersensitivity reaction Side effects include lactic acidosis

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48
Q

Lamivudine

A

Nucleoside Reverse Transcriptase Inhibitor (NRTI) Treats HIV and HBV Safe during pregnancy Side effects include lactic acidosis

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49
Q

Didanosine

A

Nucleoside Reverse Transcriptase Inhibitor (NRTI) Treats HIV Side effects include lactic acidosis, pancreatitis, peripheral neuropathy

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50
Q

Stavudine

A

Nucleoside Reverse Transcriptase Inhibitor (NRTI) Side effects include lactic acidosis, pancreatitis, peripheral neuropathy

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51
Q

Tenofovir

A

Nucleotide Reverse Transcriptase Inhibitor (NRTI) Doesn’t require primary phosphorylation so effective in resting cells Nephrotoxic (Fanconi’s syndrome –> phosphaturia, glucosuria)

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52
Q

Nevirapine

A

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) Prophylaxis in pregnancy Side effects include rash, hepatotoxicity, drug-drug interactions (CYP3A4), Stevens Johnson Syndrome

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53
Q

Rilpivirine

A

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) Side effects include rash, hepatotoxicity, drug-drug interactions (CYP3A4) Contraindicated with other NNRTIs due to cross resistance

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54
Q

Etravirine

A

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) Recommended for patients with resistance to other NNRTIs Side effects include rash, hepatotoxicity, unpredictable drug-drug interactions (CYP3A4)

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55
Q

Efavirenz

A

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) Side effects include rash, hepatotoxicity, drug-drug interactions (CYP3A4), vivid dreams, CNS symptoms Contraindicated in pregnancy

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56
Q

Delavirine

A

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) Side effects include rash, hepatotoxicity, drug-drug interactions (CYP3A4) Contraindicated in pregnancy

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57
Q

Maraviroc

A

Inhibits binding of gp120 to CCR5 Not effective if CXCR4 tropism

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58
Q

Enfuviritide

A

Locks gp41 in extended conformation Injected subcutaneously

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59
Q

Raltegravir

A

Integrase inhibitor Side effects include hypercholesterolemia

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60
Q

Atazanavir

A

HIV Protease inhibitor Side effects include lipodystrophy, dyslipidemia, hyperglycemia, insulin resistance, cardiac conduction abnormalities Lower incidence of lipodystrophy

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61
Q

Darunavir

A

HIV Protease inhibitor Side effects include lipodystrophy, dyslipidemia, hyperglycemia, insulin resistance, cardiac conduction abnormalities Given with rotinavir

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62
Q

Fosamprenavir

A

HIV Protease inhibitor Side effects include lipodystrophy, dyslipidemia, hyperglycemia, insulin resistance, cardiac conduction abnormalities

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63
Q

Indinavir

A

HIV Protease inhibitor Side effects include lipodystrophy, dyslipidemia, hyperglycemia, insulin resistance, cardiac conduction abnormalities, nephropathy (nephrolithiasis)

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64
Q

Lopinavir

A

HIV Protease inhibitor Side effects include lipodystrophy, dyslipidemia, hyperglycemia, insulin resistance, cardiac conduction abnormalities Given with rotinavir Recommended during pregnancy

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65
Q

Ritonavir

A

HIV Protease inhibitor Side effects include lipodystrophy, dyslipidemia, hyperglycemia, insulin resistance, cardiac conduction abnormalities Recommended during prenancy Strongly inhibits CYP3A4

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66
Q

Saquinavir

A

HIV Protease inhibitor Side effects include lipodystrophy, dyslipidemia, hyperglycemia, insulin resistance, cardiac conduction abnormalities

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67
Q

Ribavirin

A

Inhibits HCV, RSV purine biosynthesis and interferes with RNA metabolism Use with IFNα Side effect include hemolytic anemia Contraindicated in pregnancy

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68
Q

Sofosbuvir

A

Inhibits HCV RNA synthesis by inhibiting polymerase Genotyping to determine if combination therapy needed (IFNα and ribavirin)

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69
Q

Boceprevir

A

HCV protease inhibitor Use with IFNα and ribavarin

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70
Q

Telaprevir

A

HCV protease inhibitor Use with IFNα and ribavarin

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71
Q

Simeprevir

A

HCV protease inhibitor Use with IFNα and ribavarin

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72
Q

Trimethoprim/Sulfamethoxazole (TMP-SMX)

A

Antibiotic Treatment and prevention of PCP in HIV+ patients Side effects include N/V, fever, rash, neutropenia, thrombocytopenia

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73
Q

Pentamidine

A

IV form treats PCP Aerosolized form is PCP prophylaxis (but not protection against disseminated PCP or toxo) Side effects include nephrotoxicity, hypoglycemia, hepatotoxicity, hypotension, pancreatitis, prolong QT (torsades), low magnesium

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74
Q

Dapsone

A

Inhibits synthesis of dihydrofolic acid Treatment or prophylaxis for PCP (also protects against toxo) Treatment for Hansen’s disease Comes in liquid form Check for G6PD deficiency –> hemolytic anemia Side effect include rash, fever, bone marrow suppression Contraindicated in patients with a sulfa allergy

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75
Q

Cryptococcus neoformans

A

Yeast Large capsule Found in soil, pigeon droppings Can cause meningitis, pneumonia

76
Q

MMR Vaccine

A

Live-attenuated vaccine against measles, mumps, and rubella Rubella component may induce arthralgias

77
Q

Parvovirus B19

A

Icosahedral, nonenveloped, ssDNA Virus is transmitted through respiratory droplets and infects RBC precursors Causes erythema infectiosum (slapped cheek rash), aplastic crisis in people with chronic hemolytic anemia, hydrops fetalis, polyarthritis (esp. in adult women) Can cross placenta

78
Q

Roseola

A

Caused by HHV-6 and HHV-7 Causes infectious mononucleosis, febrile seizures Causes fever, encephalitis, pneumonitis in immunocompromised

79
Q

Varicella

A

Caused by varicella zoster virus Primary infection = chickenpox; vesicular lesions of different ages Recurrent infection = shingles; vesicular lesions in dermatomal distribution

80
Q

For which viruses are there live attenuated vaccines?

A

Vaccinia Polio Yellow fever Measles Mumps Rubella Rotavirus Adenovirus Varicella

81
Q

From which viruses are there killed vaccines?

A

Rabies Polio Influenza Hepatitis B Hepatitis A Japanese encephalitis Papilloma

82
Q

What viruses are associated with a maculopapular rash?

A

Measles Rubella Scarlet fever Roseola Parvovirus B19 Rash-associated enteroviruses

83
Q

Bordetella pertussis

A

Gram - coccobacilli Encapsulated Requires fatty acid for culture (Bordet-Gengou agar or Regan Lowe charcoal with horse blood) Colonizes ciliated bronchial epithelia –> tracheal cytotoxin damages epithelium –> activation of adeylyl cyclase increases cAMP thus increasing fluid secretion (pertussis toxin) –> pertussis toxin causes systemic problems without bacteremia Causes pertussis (whooping cough) DTaP vaccine for children

84
Q

Corynebacterium diphtheriae

A

Gram + rod Catalase + “Chinese letters” Causative agent of diphtheria Pseudomembrane may occlude airways The toxin can be cleaved into a fragment that catalyzes the NAD+ -dependent ADP-ribosylation of elongation factor 2, thereby inhibiting protein synthesis Treat with horse antitoxin Prevent with DTaP vaccine

85
Q

Escherichia coli

A

Gram - rod Lactose-fermenting Pink on MacConkey agar

86
Q

Klebsiella pneumoniae

A

Gram - rod Lactose-fermenting Pink on MacConkey agar Mucoid colonies

87
Q

Clostridium difficile

A

Gram + Spore-forming (resistant to alcohol-based antiseptics) Toxin mediates watery diarrhea, leukocytosis, and psueomembranous colitis

88
Q

Acinetobacter baumannii

A

Gram - rod Non-lactose fermenting (non-pink colonies on MacConkey agar) Can cause nosocomial pneumonia, bacteremia, wound infections, UTIs

89
Q

Isoniazid

A

Inhibits synthesis of mycolic acids in the cell wall of mycobacterium TB treatment and prophylaxis Side effects include neuropathy –> take concurrently with pyridoxine (vitamin B6), interactions with phenytoin

90
Q

Rifampin

A

Inhibits bacterial DNA-dependent RNA-polymerase Treats TB Prophylaxis against H. influenza meningitis and staph Lots of drug interactions Side effects include orange-red discoloration of urine, feces, saliva

91
Q

Ethambutol

A

Inhibits arabinogalactan synthesis Treats TB Avoid in children May cause optic neuritis (decreased visual acuity and red-green colorblindness)

92
Q

Pyrazinamide

A

Inhibits fatty acid synthetase 1 Treats TB Side effects include hepatotoxicity, gouty and non-gouty arthralgia

93
Q

Clofazimine

A

May inhibit template function of DNA Treats lepromatous Hansen’s disease Side effects include red discoloration of the skin

94
Q

Cyclosporine A

A

Calcineurin inhibitor prevents NFAT-mediated transcription of IL-2 Prevents acute rejection of solid organs and GVHD, RA, chronic dry eye Side effects include nephrotoxicity, drug interactions

95
Q

Tacrolimus

A

Binds FKBP-12 that inhibits calcineurin Prevents acute rejection of solid organs, atopic dermatitis Less nephrotoxic than CsA

96
Q

Sirolimus (rapamycin)

A

Binds FKBP-12 that inhibits mTOR and blocks transcription and translation of IL-2 Prevents renal allograft rejection (no nephrotoxicity) Contraindicated in liver/lung transplants

97
Q

Mycophenolate mofetil (MMF)

A

Prodrug hydrolyzed by liver to MPA which inhibits de novo purine biosynthesis Used for kidney, heart, liver transplants, esp. with calcineurin inhibitor toxicity

98
Q

Azathioprine

A

Metabolized to 6-mercaptopurine and disrupts de novo purine synthesis Prevents organ rejection, treats severe RA

99
Q

Methotrexate

A

Folic acid analogue inhibits dihydrofolate reductase to reduce nucleoside biosynthesis First line RA treatment (DMARD) Contraindicated in pregnancy

100
Q

Sulfasalazine

A

Scavenger of ROS produced by neutrophils Treats RA, Chron’s

101
Q

Penicillamine

A

Prevents IL-1 generation and collagen maturation Metal chelator Treats RA, Wilson’s disease, heavy metal poisoning Contraindicated in pregnancy and renal disease

102
Q

Chloroquine

A

Anti-malarial drug perturbs lysosomal processing and antigen presentation Treats RA Side effects include ocular toxicity

103
Q

Leflunomide

A

Prodrug whose active metabolite inhibits dihydroorotate dehydrogenase essential in pyrimidine biosynthesis Treats RA

104
Q

Tofacitinib

A

JAK inhibitor inhibits cytokine signaling (common gamma chain) Treats RA that fails MTX

105
Q

Daclizumab

A

Anti-CD25 of IL-2 receptor Reduces risk of acute rejection in kidney and cardiac transplantation

106
Q

Basiliximab

A

Anti-CD25 of IL-2 receptor Reduces risk of acute rejection in kidney and cardiac transplantation May have acute hypersensitivity

107
Q

Infliximab

A

Anti-TNF Treats Chron’s, ulcerative colitis, RA, psoriasis

108
Q

Etanercept

A

Anti-TNF Treats Chron’s, ulcerative colitis, RA, psoriasis

109
Q

Adalimumab

A

Anti-TNF Treats Chron’s, ulcerative colitis, RA, psoriasis

110
Q

Abatacept

A

CTLA4 and IgG1 Fc chimera binds CD80/86 (B7) on APCs to prevent T cell costimulation through CD28 engagement Treats RA

111
Q

Muromonab

A

Anti-CD3 on TCR Reverses rejection of heart, liver, kidney transplants Side effects include hypersensitivity and activation of T cells

112
Q

Anakinra

A

IL-1 receptor antagonist Treats RA Increased risk of serious bacterial infections

113
Q

Tocilizumab

A

Anti-IL-6 receptor Treats RA

114
Q

Rituximab

A

Anti-CD20 Treats RA, non-Hodgkin’s lymphoma, CLL

115
Q

Natalizumab

A

Anti-VLA4 inhibits lymphocyte migration to sites of inflammation Treats Chron’s disease and MS a/w JC virus-induced PML

116
Q

Omalizumab

A

Anti-IgE Fc (won’t cross-link IgE already bound) –> Type I HS Treats allergic asthma unresponsive to corticosteroids

117
Q

Fingolimod

A

Binds sphingosine-1 phosphate receptors to prevent lymphocytes from migrating out of lymph nodes Treats MS Increased risk of fatal infections

118
Q

IFN-β

A

Decreases T cell proliferation and activation and inhibits leukocyte migration across BBB Treats MS

119
Q

Epoetin alpha

A

EPO analogue stimulated formation of RBCs

120
Q

Darbepoetin alpha

A

EPO analogue stimulated formation of RBCs Longer half-life than epoetin alpha

121
Q

Filgastrim

A

G-CSF stimulated neutrophil proliferation and maturation

122
Q

Penicillin G

A

Penicillinase-sensitive penicillin (β-lactam) IV or IM Bactericidal for G (+/-) Cocci / G (+) Rods / Spirochetes Hypersensitivity, hemolytic anemia

123
Q

Penicillin V

A

Penicillinase-sensitive penicillin (β-lactam) Oral Bactericidal for G (+/-) Cocci / G (+) Rods / Spirochetes Hypersensitivity, hemolytic anemia

124
Q

How do β-lactam antibiotics work?

A

Antibiotic binds penicillin-binding proteins (transpeptidases) that blocks cross-linking of peptidoglycans –> inhibits cell wall synthesis

125
Q

Ampicillin

A

Extended spectrum penicillinase-sensitive penicillin (β-lactam) Same as Penicillin / Haemophilus / E. Coli / Listeria / Salmonella / Shigella Hypersensitivity reactions, rash, pseudomembranous colitis

126
Q

Amoxicillin

A

Extended spectrum penicillinase-sensitive penicillin (β-lactam) Same as Penicillin / Haemophilus / E. Coli / Listeria / Salmonella / Shigella Hypersensitivity reactions, rash, pseudomembranous colitis

127
Q

Oxacillin

A

Penicillinase-resistant penicillin (β-lactam) G (+) Cocci: S. aureus Hypersensitivity, interstitial nephritis

128
Q

Nafcillin

A

Penicillinase-resistant penicillin (β-lactam) G (+) Cocci: S. aureus Hypersensitivity, interstitial nephritis

129
Q

Dicloxacillin

A

Penicillinase-resistant penicillin (β-lactam) G (+) Cocci: S. aureus Hypersensitivity, interstitial nephritis

130
Q

Ticarcillin

A

Penicillinase-sensitive antipseudomonal penicillin (β-lactam) Pseudomonas spp. / Gram (-) Rods Hypersensitivity

131
Q

Piperacillin

A

Penicillinase-sensitive antipseudomonal penicillin (β-lactam) Pseudomonas spp. / Gram (-) Rods Hypersensitivity

132
Q

Clavulanic acid

A

β-lactamase inhibitor

133
Q

Sulbactam

A

β-lactamase inhibitor

134
Q

Tazobactam

A

β-lactamase inhibitor

135
Q

Cephazolin

A

1st generation cephalosporin IV or IM G (+) Cocci / Proteus Mirabilis / E. Coli / Klebsiella pneumoniae / Used prior to surgery to prevent S. aureus

136
Q

Cephalexin

A

1st generation cephalosporin G (+) Cocci / Proteus Mirabilis / E. Coli / Klebsiella pneumoniae

137
Q

Cefoxitin

A

2nd generation cephalosporin G (+) Cocci / H. Flu, Enterobacter, Neisseria, Proteus, E. Coli, Klebsiella, Serratia

138
Q

Cefaclor

A

2nd generation cephalosporin G (+) Cocci / H. Flu, Enterobacter, Neisseria, Proteus, E. Coli, Klebsiella, Serratia

139
Q

Cefuoxime

A

2nd generation cephalosporin G (+) Cocci / H. Flu, Enterobacter, Neisseria, Proteus, E. Coli, Klebsiella, Serratia

140
Q

Ceftriaxone

A

3rd generation cephalosporin Serious G (-) / meningitis / gonorrhea

141
Q

Cefotaxime

A

3rd generation cephalosporin Serious G (-)

142
Q

Ceftazidime

A

3rd generation cephalosporin Serious G (-) / Pseudmonas

143
Q

Cefipime

A

4th generation cephalosporin G (+) / Pseudomonas

144
Q

Ceftaroline

A

5th generation cephalosporin Gram (+/-) / MRSA

145
Q

Azotreonam

A

Monobactam Resistant to β-lactamase Gram (-) rods only Synergistic with aminoglycosides

146
Q

Imipenem

A

Carbapenem Resistant to β-lactamase G (+) Cocci / G (-) Rods / Anaerobes Always give with cilastatin which slows inactivation of drug in kidney

147
Q

Meropenem

A

Carbapenem Resistant to β-lactamase G (+) Cocci / G (-) Rods / Anaerobes

148
Q

Ertapenem

A

Carbapenem Resistant to β-lactamase G (+) Cocci / G (-) Rods / Anaerobes

149
Q

Doripenem

A

Carbapenem Resistant to β-lactamase G (+) Cocci / G (-) Rods / Anaerobes

150
Q

Vancomycin

A

Glycopeptide G (+) / C.diff / MRSA / enterococci Gram + because too big to fit into porin channels Nephrotoxicity, ototoxicity, thrombophlebitis Red man syndrome if infusion rate too fast

151
Q

Bacitracin

A

Glycopeptide G (+/-)

152
Q

How do glycopeptides work?

A

Binds to D-ala-D-ala portion of cell wall precursors which inhibits cell wall synthesis

153
Q

Gentamicin

A

Aminoglycoside G (-) Rods (severe) Synergistic with β-lactams Nephrotoxic, ototoxic, neuromuscular blockage, teratogenic

154
Q

Neomycin

A

Aminoglycoside G (-) Rods (severe) / bowel surgery Synergistic with β-lactams Nephrotoxic, ototoxic, neuromuscular blockage, teratogenic

155
Q

Amikacin

A

Aminoglycoside G (-) Rods (severe) Synergistic with β-lactams Nephrotoxic, ototoxic, neuromuscular blockage, teratogenic

156
Q

Tobramycin

A

Aminoglycoside G (-) Rods (severe) Synergistic with β-lactams Nephrotoxic, ototoxic, neuromuscular blockage, teratogenic

157
Q

Streptomycin

A

Aminoglycoside G (-) Rods (severe) Synergistic with β-lactams Nephrotoxic, ototoxic, neuromuscular blockage, teratogenic

158
Q

How do aminoglycosides work?

A

Inhibits formation of the initiation complex (30S) and causes misreading of mRNA

159
Q

Tetracycline

A

Tetracycline M. pneumoniae / Rickettsia / Chlamydia Discoloration of teeth, inhibition of bone growth in children, photosensitivity Contraindicated in pregnancy Avoid milk, antacids (divalent cations inhibit absorption)

160
Q

Doxycycline

A

Tetracycline M. pneumoniae / Rickettsia / Chlamydia Discoloration of teeth, inhibition of bone growth in children, photosensitivity Contraindicated in pregnancy Avoid milk, antacids (divalent cations inhibit absorption)

161
Q

Minocycline

A

Tetracycline M. pneumoniae / Rickettsia / Chlamydia Discoloration of teeth, inhibition of bone growth in children, photosensitivity Contraindicated in pregnancy Avoid milk, antacids (divalent cations inhibit absorption)

162
Q

How do tetracyclines work?

A

Binds to 30S and prevents attachment of aminoacyl-tRNA

163
Q

Azithromycin

A

Macrolide Atypical Pneumonias (mycoplasma, chlamydia, legionella) / Chlamydia / G (+) cocci / Strep infections in pts allergic to penicillin May cause GI motility issues, arrhythmia (prolonged QT), cholestatic hepatitis, rash, eosinophilia

164
Q

Clarithromycin

A

Macrolide Atypical Pneumonias (mycoplasma, chlamydia, legionella) / Chlamydia / G (+) cocci / Strep infections in pts allergic to penicilin May cause GI motility issues, arrhythmia (prolonged QT), cholestatic hepatitis, rash, eosinophilia

165
Q

Erythromycin

A

Macrolide Atypical Pneumonias (mycoplasma, chlamydia, legionella) / Chlamydia / G (+) cocci / Strep infections in pts allergic to penicilin May cause GI motility issues, arrhythmia (prolonged QT), cholestatic hepatitis, rash, eosinophilia

166
Q

How to macrolides work?

A

Binds to 50S and blocks translocation to prevent protein synthesis

167
Q

Chloramphenicol

A

Blocks peptidyltransferase at 50S subunit Meningitis (H. flu, N. meningitides, S. pneumo), Rickettsia (Rocky Mtn Spotted Fever) Anemia, gray baby syndrome in premature infants

168
Q

Clindamycin

A

Prevents translocation at 50S Anaerobic infections: Bacteroides spp., Clostridium perfringens / GAS May cause psudomembranous colitis (C. diff), fever, diarrhea

169
Q

Sulfamethozaxole (SMX)

A

Sulfonamide Inhibits folate synthesis G (+/-), Nocardia, Chlamydia, UTIs Hypersensitivity, hemolysis if G6PD deficient, nephrotoxicity, kernicterus in infants, Stevens-Johnson Syndrome

170
Q

Trimethoprim (TMP)

A

Inhibits dihydrofolate reductase Use with SMX G (+/-), UTIs, Shigella, Salmonella, Pneumonocystis jirovecii pneumonia (tx/prophylactic), toxoplasmosis (prophylactic) Megaloblastic leukemia, leukopenia, granulocytopenia –> can supplement with folic acid

171
Q

Ciprofloxacin

A

Fluoroquinolone G (-) Rods / UTI / Pseudomonas / Neisseria / Some G (+) May cause tedonitis, myalgias Contraindicated in pregnancy, nursing mothers, children

172
Q

Levofloxacin

A

Fluoroquinolone G (-) Rods / UTI / Pseudomonas / Neisseria / Some G (+) May cause tedonitis, myalgias Contraindicated in pregnancy, nursing mothers, children

173
Q

How do fluoroquinolones work?

A

Inhibits DNA gyrase (topoisomerase II) and topoisomerase IV

174
Q

Nalidixic acid

A

Quinolone G (-) Rods / UTI / Pseudomonas / Neisseria / Some G (+) May cause tedonitis, myalgias Contraindicated in pregnancy, nursing mothers, children

175
Q

Metronidazole

A

Forms free radical toxic metabolites that damage bacterial and protozoal DNA Giardia, Entamoeba, Trichomonas / Gardnerella vaginalis, Anaerobes, H. Pylori

176
Q

Which antibiotics are concentration-dependent?

A

Aminoglycosides Daptomycin Quinolones

177
Q

Which antibiotics are time-dependent?

A

β-lactams Vancomycin

178
Q

Which antibiotics are AUC?

A

Chloramphenicol Clindamycin Tetracycline Glycopeptides Macrolides Sulfonamides

179
Q

Linezolid

A

Oxazolidinone Binds 50S preventing formation of initiation complex Gram (+) / MRSA

180
Q

Which antibiotics are bactericidal?

A

β-lactams Aminoglycosides Vancomycin (variable) Daptomycin (variable) Fluoroquinolones Metronidazole Type B streptogramins Nitrofurantoin Rifamycins

181
Q

Which antibiotics are bacteriostatic?

A

Macrolides Tetracylines Sulfonamides Chloramphenicol (variable) Clindamycin Trimethoprim Linezolid

182
Q

Belatacept

A

CTLA4 and IgG1 Fc chimera binds CD80/86 (B7) on APCs to prevent T cell costimulation through CD28 engagement Cobo therapy for transplants

183
Q

Belimumab

A

Anti-BAFF (anti-B cell) Treats SLE

184
Q

Golimumab

A

Anti-TNF Treats Chron’s, ulcerative colitis, RA, psoriasis

185
Q

How do you treat anaphylaxis?

A

Avoid the trigger OR IM epinephrine to reverse bronchoconstriction and vasodilation Remove antigen Anti-histamines Corticosteroids IV fluids to counteract hypotension

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